Crease disappeared after ptosis repair, could a revisional surgery recreate a crease? (photo)

I had surgery 11 months ago to repair a congenital left ptosis, with minor blepharoplasty. I no longer have a definitive eyelid crease, and feel I look more assymetrical now than before surgery. I also feel that I still have some residual ptosis.  I look forward to any advice..

Doctor Answers 2

#eyelid aesthetics

Hi. I don't think you have a residual ptosis however there are some things about your eyelid aesthetics that could be improved. The crease can be remade by anchoring the skin to the top of the tarsal plate. You also have a slight excess of skin on the right which could benefit from a skin only excision.  The major thing that I see is that you eyes tend to tilt downwards on the outer side which gives you a sad expression.  This is harder to fix but the lateral canthal tendon can be adjusted and moved into a higher position.Hope this helpsDamien

No lid crease after ptosis repair.

It is hard to tell from the photo, but the type of surgery you had for ptosis repair may not have created a lid crease for you. When surgery is done from the inside of the eyelid (posterior repair), a small muscle is shortened to raise the eyelid. This muscle is not one that creates the fold in your skin and so won't make your lid crease. Ptosis repair done through a skin incision, where the levator muscle is adjusted, can create a defined lid crease when closed properly. I'd speak with your eyelid surgeon about this. If he/she feels a revision is in order, an external repair with lid crease formation could achieve the result you are looking for.

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

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